Pancreas-left gastric artery angle predicts difficulty of suprapancreatic lymph node dissection in gastrectomy for gastric cancer: a cross-sectional study.

IF 1.7 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-02-01 Epub Date: 2024-07-16 DOI:10.1007/s00595-024-02890-2

Ryugo Teranishi, Tsuyoshi Takahashi, Yukinori Kurokawa, Takuro Saito, Kazuyoshi Yamamoto, Kota Momose, Kotaro Yamashita, Koji Tanaka, Tomoki Makino, Kiyokazu Nakajima, Hidetoshi Eguchi, Yuichiro Doki

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引用次数: 0

Abstract

Purpose: Suprapancreatic lymph node dissection is one of the most challenging procedures performed in the treatment of gastric cancer. This study aimed to investigate whether the pancreas-left gastric artery angle (PLA) can be used to predict the difficulty of the procedure.

Methods: This was a single-center cross-sectional study. Before gastrectomy, the patients were classified according to the size of the PLA into the small PLA (s-PLA; < 30°) and large PLA (l-PLA; ≥ 30°) groups in a surgeon-blinded manner. After gastrectomy, a surgeon evaluated suprapancreatic lymph node dissection as hard, normal, or easy to perform.

Results: Seventy-three patients were enrolled in the study. Surgeons evaluated lymph node dissection as hard in 43.8 and 8.7% of patients in the s-PLA and l-PLA groups, respectively (p = 0.002). The time taken for suprapancreatic lymph node dissection was also significantly longer in the s-PLA group than in the l-PLA group (p = 0.040). In patients who underwent laparoscopic gastrectomy, the time for node dissection in the s-PLA group was also significantly longer than that in the s-PLA group (p = 0.021), while there was no difference in those who underwent robotic surgery (p = 0.815).

Conclusion: PLA is useful for predicting the degree of difficulty of suprapancreatic lymph node dissection during gastrectomy for gastric cancer.

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胰腺-胃左动脉角度预测胃癌胃切除术中胰上淋巴结清扫的难度：一项横断面研究。

目的：胰上淋巴结清扫术是胃癌治疗中最具挑战性的手术之一。本研究旨在探讨胰腺-胃左动脉角（PLA）是否可用于预测手术难度：这是一项单中心横断面研究。方法：这是一项单中心横断面研究。胃切除术前，根据胰左动脉角的大小将患者分为小胰左动脉角（s-PLA）和大胰左动脉角（s-PLA）两类：73名患者参与了研究。外科医生认为小PLA组和大PLA组分别有43.8%和8.7%的患者难以进行淋巴结清扫（P = 0.002）。胰上淋巴结清扫所需的时间，s-PLA 组也明显长于 l-PLA 组（p = 0.040）。在接受腹腔镜胃切除术的患者中，s-PLA组的淋巴结清扫时间也明显长于s-PLA组（p = 0.021），而接受机器人手术的患者则没有差异（p = 0.815）：结论：PLA可用于预测胃癌胃切除术中胰上淋巴结清扫的难度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.